Matt Taibbi – Sick and Wrong

This is a teaser. Read the whole thing here.

Sick and Wrong

How Washington is screwing up health care reform – and why it may take a revolt to fix it

By Matt Taibbi

Let’s start with the obvious: America has not only the worst but the dumbest health care system in the developed world. It’s become a black leprosy eating away at the American experiment – a bureaucracy so insipid and mean and illogical that even our darkest criminal minds wouldn’t be equal to dreaming it up on purpose.

The system doesn’t work for anyone. It cheats patients and leaves them to die, denies insurance to 47 million Americans, forces hospitals to spend billions haggling over claims, and systematically bleeds and harasses doctors with the specter of catastrophic litigation. Even as a mechanism for delivering bonuses to insurance-company fat cats, it’s a miserable failure: Greedy insurance bosses who spent a generation denying preventive care to patients now see their profits sapped by millions of customers who enter the system only when they’re sick with incurably expensive illnesses.

The cost of all of this to society, in illness and death and lost productivity and a soaring federal deficit and plain old anxiety and anger, is incalculable – and that’s the good news. The bad news is our failed health care system won’t get fixed, because it exists entirely within the confines of yet another failed system: the political entity known as the United States of America.

Just as we have a medical system that is not really designed to care for the sick, we have a government that is not equipped to fix actual crises. What our government is good at is something else entirely: effecting the appearance of action, while leaving the actual reform behind in a diabolical labyrinth of ingenious legislative maneuvers.

Over the course of this summer, those two failed systems have collided in a spectacular crossroads moment in American history. We have an urgent national emergency on the one hand, and on the other, a comfortable majority of ostensibly simpatico Democrats who were elected by an angry population, in large part, specifically to reform health care. When they all sat down in Washington to tackle the problem, it amounted to a referendum on whether or not we actually have a functioning government.

It’s a situation that one would have thought would be sobering enough to snap Congress into real action for once. Instead, they did the exact opposite, doubling down on the same-old, same-old and laboring day and night in the halls of the Capitol to deliver us a tour de force of old thinking and legislative trickery, as if that’s what we really wanted. Almost every single one of the main players – from House Speaker Nancy Pelosi to Blue Dog turncoat Max Baucus – found some unforeseeable, unique-to-them way to fuck this thing up. Even Ted Kennedy, for whom successful health care reform was to be the great vindicating achievement of his career, and Barack Obama, whose entire presidency will likely be judged by this bill, managed to come up small when the lights came on.

We might look back on this summer someday and think of it as the moment when our government lost us for good. It was that bad.


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  1. thanks for the link.

  2. Everything is so fucking obvious now, at least to those that know how to think and reason.  The government, at least the political part, didn’t lose me, it never had me.  I’ve known in my heart since the sixties and what I’ve learned since makes it clear in my mind.  How to stop the biggest menace the human race has ever encountered?  

    • dkmich on September 7, 2009 at 8:46 pm

    it is pure Taibbi gold.  Scahill is another guy who isn’t afraid to put himself on the life.  

  3. Most of the politicians making the monstrosity that the new health care bill will be are multi-millionaires. The US Senate and Congress use to not be that way.

    We have a plutocracy where the great mass of the population is just fodder for the designs of the Real People.

    • Edger on September 7, 2009 at 9:18 pm

    On July 9th, in a harmless-sounding letter to Pelosi, 40 Blue Dogs expressed concern that doctors in the public option “must be fairly reimbursed at negotiated rates, and their participation must be voluntary.” Paying doctors “using Medicare’s below-market rates,” they added, “would seriously weaken the financial stability of our local hospitals.”

    The letter was an amazing end run around the political problem posed by the public option – i.e., its unassailable status as a more efficient and cheaper health care alternative. The Blue Dogs were demanding that the very thing that makes the public option work – curbing costs to taxpayers by reimbursing doctors at Medicare rates plus five percent – be scrapped. Instead, the Blue Dogs wanted compensation rates for doctors to be jacked up, on the government’s tab. The very Democrats who make a point of boasting about their unwavering commitment to fiscal conservatism were lobbying, in essence, for a big fat piece of government pork for doctors. “Cost should be the number-one concern to the Blue Dogs,” grouses Rep. Woolsey. “That’s why they’re Blue Dogs.”

    In the end, the Blue Dogs won. When the House commerce committee passed its bill, the public option no longer paid Medicare-plus-five-percent. Instead, it required the government to negotiate rates with providers, ensuring that costs would be dramatically higher. According to one Democratic aide, the concession would bump the price of the public option by $1,800 a year for the average family of four.

    In one fell swoop, the public plan went from being significantly cheaper than private insurance to costing, well, “about the same as what we have now,” as one Senate aide puts it. This was the worst of both worlds, the kind of take-the-fork-in-the-road nonsolution that has been the peculiar specialty of Democrats ever since Bill Clinton invented a new way to smoke weed. The party could now sell voters on the idea that it was offering a “public option” without technically lying, while at the same time reassuring health care providers that the public option it was passing would not imperil the industry’s market share.

    Even more revolting, when Pelosi was asked on July 31st if she worried that progressives in the House would yank their support of the bill because of the sellout to conservatives, she literally laughed out loud. “Are the progressives going to take down universal, quality, affordable health care for all Americans?” she said, chuckling heartily to reporters. “I don’t think so.”

    The laugh said everything about what the mainstream Democratic Party is all about. It finds the notion that it has to pay anything more than lip service to its professed values funny. “It’s a joke,” complains one Democratic aide. “This is all a game to these people – and they’re good at it.”

  4. gets to the heart of quite a bit of America. I still have a subscription to RS partially because of him.

    • Joy B. on September 7, 2009 at 11:24 pm

    …boils things down so succinctly. My favorite (on lack of leadership):

    This White House makes a serial vacillator like Bill Clinton look like Patton crossing the Rhine.

  5. Just as we have a medical system that is not really designed to care for the sick, we have a government that is not equipped to fix actual crises.

    I would add though, that the US has a government very good at starting actual crisis — one after another.  

  6. Hegelian dialectic, usually presented in a three-fold manner, was stated by Heinrich Moritz Chalybäus as comprising three dialectical stages of development: a thesis, giving rise to its reaction, an antithesis, which contradicts or negates the thesis, and the tension between the two being resolved by means of a synthesis.


    The synthesis is what they had in mind all along.  Put this in the context of the teabaggers, the Gang of 6, the wingers, and all the other “noisemakers”.  Maybe it’ll make more sense.  Its Hegelian drama designed to fully corporatize America, which in the end, if they play this successfully, “mainstream” America will beg for (given the production of stress from all of the drama).  Corallary: Human nature wants stress relieved ASAP, even if the relief comes at a greater price than the stress itself.

    They think we’re too stupid to understand what they’re doing.  Hence, Pelosi’s laughter that progressives wouldn’t dare take down universal care (that isn’t really universal care).  That’s hegelian dialectic right there.  It’s why it seems like every honest thing we say or ask for, ends up blowing up in our faces.

    Caution, this quote may cause mental trauma (LOL):

    Something in its passage into other only joins with itself, it is self-related. In becoming there are two moments: coming-to-be and ceasing-to-be: by sublation, i.e. negation of the negation, being passes over into nothing, it ceases to be, but something new shows up, is coming to be. What is sublated (aufgehoben) on the one hand ceases to be and is put to an end, but on the other hand it is preserved and maintained. In dialectics, a totality transform itself, it is self-related.

    Basically, it takes the name people know it as and glooms that onto a monstrosity that will harm the very people who end up wanting it, to make the stress go away, hence, it becomes another, but includes itself.  So when you attack the monstrosity, they shield themselves behind the name.  Game, set, match.

    Good management begins with honesty.  Until this double speak is flushed, we will never have proper management.  Honesty is the counter to the dialectic.  Somehow, we always attack the first negation, the antithesis (e.g. the teabaggers), which then initiates the synthesis.  How much energy have we wasted on Glen Beck this summer?  He is locked into a media market that represents 1% of the American population.  Attacking the antithesis (Beck, 1% pop), initiates the synthesis (Van Jones resigns, 54% pop).  Not a good trade was it?  Beck is still there, Van isn’t, and they are already moving on to new targets.

    To fight it: Anticipate the synthesis, diffuse the stress immediately, reveal the process, and expose the dishonesty by attacking the HEAD.  And know, they will ALWAYS approach things this way.  Because of the deception, think the thing through backwards.  Start with the synthesis, and think back toward the thesis.  Practise on past bogeymen that were well documented.  I like to play around with the Y2K boondoogle for this (the emotion is long gone now).

    And always remember this:  to increase knowledge is to increase misery.  (I know I’m worse off for knowing what utterly deceptive people our leaders are.  Pay attention to the utterances of the staffers in the report…that is beyond frustation…it is the early signs of misery as they sense the deception).

    Figuring it out though is: “like shoveling smoke with a pitchfork in the wind”, John Lennon

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